DYSTROPHIA ADIPOSOGENITALIS 



883 



philes 1 ,per cent, lymphocytes 26.5 per cent, large mononuclears 5 per 

 cent, transitionals 3 per cent. 



Treatment consisted at first of pituitary (whole gland) followed by 

 a combination of pituitary and thyroid to which subsequently was added 

 suprarenal gland. Despite thyroid medication basal metabolism was 4 

 per cent below normal. The patient improved on all of the above plans 

 of treatment. He became less infantile in his habits ; condition of hair and 

 fat dystrophy improved; testicles descended and 

 genitalia showed signs of development. 



Illustrative Case II (Fig. 12). The following 

 case presents the typical syndrome of dystrophia 

 adiposogenitalis in the female: The patient, 

 twenty-four years of age, was employed as a 

 cashier. Except for a sister, who was suffering 

 from goiter, her family history was negative. As 

 a child she had scarlet fever and measles, and later 

 occasional sick-headaches; otherwise her general 

 health had been good, and her development 

 both mental and physical normal. The onset 

 of her symptoms dated to an attack of grippe 

 from which she suffered eighteen months pre- 

 vious to examination. Following this attack men- 

 struation, which had always been regular and 

 normal from the age of fourteen, became scant 

 and after three months ceased entirely. Five 

 months later an intense polyuria developed. Her 

 average weight, which was one hundred and five 

 pounds, remained stationary for thirteen months 

 after cessation of .menstruation, then there was 

 a sudden increase due to a rapidly develop- 

 ing obesity, gaining twenty-two pounds in five 

 weeks. In two months, at the time of examination, 

 she had gained twenty-eight pounds and subsequently reached one hundred 

 and forty-nine pounds. The obesity was of the girdle type with broad hips, 

 large, tapering thighs, and excessive accumulation of subcutaneous fat in 

 the lower abdominal wall. In addition she observed a slight increase in 

 the size of her breasts and some local deposits of fat over her shoulders. 

 There was no increase in the size of the face, neck, forearms and hands, 

 legs and feet. 



The skin was dry, thin and peculiarly delicate, white and transparent 

 (alabaster skin). The fingers were tapering, and the hair, with the ex- 

 ception of some scantiness of the eyebrows, was normal in character and 

 distribution. 



Fig. 12. GROUP A, 

 CASE XV, showing fat 

 dystrophy at end of 2 

 months from the time 

 she began to increase in 

 weight. Note the size 

 and shape of the upper 

 thighs, gluteals and abdo- 

 men. 



